Illinois is emerging as an oasis in a desert of reproductive freedom.  

Surrounded by states with near-total abortion bans post-Dobbs, Illinois Governor J.B. Pritzker and fellow Democrats expanded protections for abortion and gender-affirming care providers and out-of-state patients this legislative session.  

The new law also mandates state-regulated insurance coverage for abortion medication, HIV prevention drugs like PEP and PrEP, and gender-affirming care at no extra cost to consumers. In addition, legislators allocated $8 million in the FY2024 budget for training for reproductive care providers and a specialty consultation program for at-risk patients.  

Since the overturn of Roe, patients have poured into the safety of Illinois’s borders, where the number of abortions performed in the first six months of 2023 rose 69% compared to all of 2020. Although staggering, this surge is unsurprising given that neighboring states ranked among the worst in the country for reproductive rights even before the Dobbs ruling, according to IWPR’s 2022 Reproductive Rights Index  

The Index, which assessed and ranked women’s access to reproductive health care across all 50 states according to a number of key indicators, gave Illinois a B ranking, even prior to lawmakers’ latest expansion of protections.   

Iowa and Indiana, on the other hand, both earned a D ranking, and reproductive restrictions have since tightened. Though it remains blocked by a judge, Iowa Governor Kim Reynolds signed into law a 6-week abortion ban this July, in addition to the ban on gender-affirming care for minors that she approved in March. Similarly, Indiana’s near-total abortion ban took effect in August, and the state’s ban on gender-affirming care is currently blocked by a federal judge.  

Wisconsin scored slightly higher with a C and still retains on the books an archaic law dating back to 1849, which prevented abortion care in the state until a judge’s recent ruling. Wisconsinites narrowly avoided the loss of Medicaid coverage for gender-affirming care in a budget provision vetoed by Governor Evers.  

To the south, Missouri ranked 51st in the nation with a failing score, and Kentucky wasn’t far ahead, earning a D+. Using 2017 data, IWPR estimated that in both Missouri and Kentucky, fewer than 25% of women reside in a county with an abortion provider.  

Restrictions on reproductive care adversely impact the health and well-being of women, as well as the economic health of the state, and Missouri paid dearly: IWPR found that the state experienced an economic loss totaling $5.3 billion as a result of its reproductive restrictions. 

While both states have enacted near-total abortion bans and gender-affirming care bans, Missouri families are fighting in court to challenge the latter, and voters in Kentucky rejected a ballot measure that would constitutionally eliminate the right to abortion, unwilling to further restrict it in the wake of legislators’ ban.

Many out-of-state patients seeking abortion care in Illinois are at high risk for pregnancy complications and experience challenges connecting with the level of care they need. Some patients arrive at clinics when a hospital would be better suited to meet their medically complex needs. To better triage the influx of out-of-state patients, the Governor’s Office launched a hotline—the Complex Abortion Regional Line for Access (CARLA)—where nurses stand ready to help patients navigate the state’s care system. The hotline is a joint initiative with the Chicago Abortion Fund, which will also connect callers with funding for care, transportation, and child care costs accrued during treatment and recovery.  

Illinois didn’t stop there. The state’s Department of Commerce and Economic Opportunity tapped Illinois’s $45 billion infrastructure fund to create a $5 million grant program for reproductive care providers, which can be used to purchase vehicles for mobile care units. Medicaid recipients will also have access to a new family planning program that covers annual preventative exams, family planning counseling, basic infertility counseling, screenings for cancers related to reproductive organs, and all FDA-approved methods of contraception, tubal ligation, vasectomies, and abortion.  

Despite these critical investments in access to reproductive care, so-called crisis pregnancy centers (CPCs) still outnumber abortion clinics 3 to 1 in Illinois. These centers are infamous for employing confusion tactics, situating themselves near clinics and offering services like ultrasounds, all while doling out misinformation about risks associated with abortion care and thwarting patients’ attempts to reach abortion providers.  

Attorney General Kwame Raoul led the state’s charge to crack down on CPCs through an expanded consumer fraud act, which allows lawsuits against centers that engage in deceptive acts to deter patients from seeking abortion care. The ink was still fresh on the updated consumer fraud act when anti-abortion advocates filed a lawsuit arguing the expansion infringes CPCs’ First Amendment rights. A federal judge has temporarily blocked the law.  

Since the Supreme Court’s decision to overturn Roe v. Wade, Illinois has demonstrated how states can draw from an arsenal of resources across the executive, judicial, and legislative branches of government to protect reproductive freedom and expand access to patients beyond their borders. A safe haven for reproductive care, Illinois is also an exemplary policy leader when it comes to activating resources and bolstering programs to promote regional access to fundamental rights.